I was a medical student about 25 years ago, when surgery was one subject in MBBS and Orthopaedics was a subspeciality. Specialist training
was introduced in Orthopaedics a few years before that and it was recognised as a welcome change, as the skills required in Orthopaedic surgery were significantly different compared to other surgical specialities. As our knowledge and technologies advanced, Orthopaedics itself has become a vast field now and we are now able to offer a variety of non operative and operative solutions to many orthopaedic problems.
Orthopaedics is now categorised into subspecialities such as Spine surgery, Arthroscopy & Sports medicine, Joint replacements, Trauma management, Paediatricorthopaedics, Hand surgery, Foot & Ankle surgery and so on. Basic training of how to deal with bones, joints and muscles are required in all subspecialities. The skills required in the surgical treatment aspects of subspecialities of orthopaedics is varied, depending on the subspeciality. Spine surgery requires training with microscopes and endoscopes as most of the spinal surgeries are done with a minimally invasive technique and training is also required to handle neural tissues. Arthroscopic surgery requires what we call as triangulation and three dimensional spatial orientation, as the surgeon is viewing a monitor whilst operating on a patient with specialist equipment. Joint replacement requires various bone cement fixation techniques and a thorough understanding of the materials used. Trauma surgery requires understanding of the forces and effects involved in trauma and also an understanding of various fixation techniques. Paediatricorthopaedics requires knowledge of how to deal with a growing skeleton. Hand surgery requires training in microsurgical techniques, as the neurovascular structures in hand are often very small. Foot and ankle surgery requires a thorough understanding of gait and its effects on various joints.
A good orthopaedic surgeon should have a basic understanding and treatment possibilities of all the subspecialities of orthopaedics, as many of these problems could coexist across subspecialities. However, it not easy for one person to master all these surgical techniques. Hence, there is a lot of subspecialisation in modern Orthopaedics and as a patient it is important to understand the capabilities of your surgeon before subjecting yourself to treatment. Specialist Orthopaedic and Spinal surgery centers should be able to offer you surgeons trained properly in different subspecialities of orthopaedics which should give better surgical outcomes.
-Dr S S Kumar
Fix Appointments: +91 9677311333